Name Badge Order

Payroll Deduction Acknowledgment

I acknowledge and authorize a one-time payroll deduction of $8.00 for the cost of my new name badge.
Your current photo on file will be used for your new badge. If you would like to update your photo, you may email a work-appropriate picture to hr@uvrc.com before your badge is produced.

Please share the link below with any staff member who needs to order a new name badge. Because the form includes authorization for a payroll deduction, requests must be submitted by the employee. Supervisors or other staff may not complete the form on an employee’s behalf.

Name

This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email(Required)

Department(Required)

Will you be submitting a new picture?(Required)

Yes

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